Rainbow-colored banners were seen flying throughout Washington, D.C., in June for Capital
Pride, an annual event celebrating lesbian, gay, bisexual
and transgender
(LGBT) communities
in D.C. and nationwide. In commemoration of LGBT pride month, NIH focused on health issues in that community as part of its Health Disparities Seminar Series.

Dr. John Ruffin, director of the National Institute
on Minority Health and Health Disparities,
welcomed Dr. Judith Bradford to address the health care challenges faced by the LGBT community. Today, around 4 million individuals identify themselves as lesbian, gay, bisexual or transgender.

Bradford emphasized that the LGBT community
is unique in the amount and types of diversity it contains and that this diversity equates to different
health needs for a less-understood population.
Research related to the LGBT community has simply

Continued...

It was only in the early 1990s that the National Opinion Research Center (NORC) conducted the National Health and Social Life Survey, widely regarded as the most authoritative national survey
including sexual orientation measures to date.

“It all began with this study,” Bradford said. “‘It all’ meaning: What do we know about people who have same-sex attraction, behavior or identity? Who are they, how many of us are there, how do we even think of counting or finding them?”

People began to realize what kind of diversity lay within the LGBT community. It wasn’t just a sexual
minority population, but it was also ethnically, culturally and behaviorally diverse.

“Diversity within this population is not just how we identify or behave or what we desire, but is also the diversity within us according to our demographic characteristics,” Bradford said.

While the NORC study was an important starting
point, researchers realized that collecting data on the LGBT community was a complicated task. Studies often phrase their questions differently
and Bradford noted how critical it is to look at how the questions are being asked and to understand
what they may mean to those answering them. For example, while some people might be attracted to a particular gender they may not necessarily
say they identify as the corresponding sexual orientation.

Says Bradford, “For all of us who are sexual and gender minorities, this is about how important it is just to be recognized, because you matter.”

Photos: Bill Branson

This is why demographic research is something Bradford has prioritized. She recently served on the study committee for an Institute of Medicine report titled, “The Health of LGBT People: Building
a Foundation for Better Understanding.” The principal finding was the overall lack of research in many areas of LGBT health. Bradford noted that research had been conducted unevenly; for example, more data is available on gay and lesbian populations than bisexual and transgender people,
less data is available on adolescents and sub-populations and there is very little data on those with disabilities within the LGBT population.

The IOM report recommends that more data be collected through federally funded surveys, but Bradford is helping take population research a step further. She is director of the Center for Population Research in Lesbian, Gay, Bisexual and Transgender Health at the Fenway Institute in Boston, offering a summer program with the goal to support development of the next generation
of LGBT health population scientists. Funded by NICHD, the program provides students
with foundations in population research for LGBT health and data analysis training.

“It’s remarkable that we are able to have a program
like this. For all of us who are sexual and gender minorities, this is about how important it is just to be recognized, because you matter,” says Bradford.

While it is an internally diverse community, there is a troublesome similarity that extends throughout the LGBT community when compared
to the heterosexual population: high-risk behavior. A recent CDC study showed that sexual minority students are more likely to engage in risky behavior, ranging from violence, attempted suicide, tobacco and alcohol use, drug use, sexual behaviors and weight management.
Across LGBT population groups, tobacco
use is substantially greater than among heterosexuals.
Health dissimilarities extend into adulthood when many LGBT individuals live in poverty and without family support.

“We know the LGBT population has unique health experiences and needs, but as a nation, we do not know exactly what these are,” said Bradford. “I’m grateful to the NIH for commissioning
the IOM report and giving us increased confidence that the work we’ve been doing for a long time is paying off. This report and other national initiatives will make it possible for us to bring more and more data forward.”